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DIEP Flap Procedure

The possibilities and techniques for breast reconstruction following a mastectomy have expanded tremendously. And the DIEP flap procedure (Deep Inferior Epigastric artery Perforator Flap) is one of the most sophisticated breast reconstruction procedures performed today. Due to its complexity, however, few surgical teams currently perform them. The surgeons at East Coast Advanced Plastic Surgery’s Center for Breast Reconstruction are proud to offer this remarkable reconstructive surgery to our patients. One of our most fundamental missions is to offer breast cancer survivors the most advanced and beneficial procedures to help them feel comfortable and whole in their own bodies again.

What happens during a DIEP flap procedure?

A DIEP procedure begins with the same lower abdominal incision as a TRAM flap procedure or an abdominoplasty (tummy tuck). The surgeon then transplants the skin and fat from the area between the belly button and the pelvis to rebuild a natural shaped breast. In contrast to a standard TRAM abdominal flap procedure, in a DIEP flap procedure the abdominal muscles are left fully intact, which preserves the normal abdominal anatomy and reduces the occurrence of abdominal wall hernias and weakness.

While DIEP flap procedures are an excellent choice for many women, others may be better suited to different reconstructive methods. During your one on one consultation with your ECAPS surgeon, your doctor will help you determine whether or not you are a good candidate for a DIEP flap procedure.

Am I a good candidate for DIEP Flap surgery?

You may be a good candidate for DIEP Flap procedure if one or more of the following are true:

During your one-on-one consultation with a surgeon at one of our ECAPS offices in New Jersey, you will go over these considerations in order to ensure that your surgery is a success. It is important to note that the look and feel of a reconstructed breast will never be identical to that of a natural breast. Open, honest discussion of your desired breast size and expected outcome will determine whether your desires can be realistically achieved. You should be prepared to discuss your full medical history during your consultation, including any medical conditions, previous surgeries or treatments, drug allergies, current medications, and use of alcohol, tobacco, or illegal substances.

Considerations for a DIEP Flap procedure:

The following factors are also important to consider prior to undergoing a DIEP flap procedure:

Age: Breast reconstruction for breast cancer patients may be performed at any age, but it is best if the breast has fully stopped developing.

Cancer Treatment: Ongoing cancer treatments can affect the optimal timing of certain procedures, and can dictate which procedures are performed at which time. It is important to discuss with your plastic surgeon how your cancer treatment will affect your reconstruction. At times, multiple procedures may be necessary for optimal reconstruction outcomes.

Pregnancy: It is important to inform your New Jersey area cosmetic surgeon if you are considering having children in the future. Pregnancy can cause bodily changes, which can affect the long-term results of your surgery.

Surgery and Recovery

Depending on the type of tissue used in your surgery, breast reconstruction surgery typically requires admission to the hospital for 3-5 days. 
After a DIEP flap procedure, you are usually able to walk the following day, and will be up and about in the hospital room within the first 24 hours of surgery. The hospital stay is required because it is necessary for nurses to attend to monitoring of the abdominal flap. You should also expect a catheter to drain urine for 24 hours, compression stocking on your legs, and drains that will remove fluid from the breasts and the abdomen.

Your breasts and abdomen will be sore and tender to the touch for the first few days following surgery. It is important that you do not lift, bend, pull, or push anything, and do not engage in any strenuous activity for at least two weeks following your surgery. More specifically, you will not be allowed to lift anything greater than 5 pounds for at least 4-6 weeks and usually will remain home from work for 2-4 weeks depending on your occupation.

Drainage tubes are usually removed after 5-10 days, and dressings will be removed within several days. You may be required to wear a supportive garment for comfort and to minimize swelling. Over time, some of your breast sensation may return. Scarring will improve, but will never fade completely. You should be able to resume normal activities after 6-8 weeks. It is important to remember that not all recovery processes are the same, and your experience may vary depending on your individual case.

You will be sent home with a list of detailed care instructions to ensure that your recovery process is a success. Your East Coast Advanced Plastic Surgery surgeon will be there to support you through every step of the process— from initial consultation through recovery.